title: Health care costs associated with child maltreatment: impact on medicaid.
abstract: OBJECTIVE
  To estimate the increased Medicaid expenditures associated with child maltreatment.
  
  
  METHODS
  Data on child maltreatment were collected from the National Survey of Child and Adolescent Well-Being, a nationally representative sample of cases investigated or assessed by local Child Protective Services agencies between October 1999 and December 2000. Medicaid claims data for 2000 to 2003 were obtained from the Medicaid Analytic Extract (MAX). Children from the National Survey of Child and Adolescent Well-Being who had Medicaid were matched to the MAX data by Social Security number or birthdate, gender, and zip code. Propensity score matching was used to select a comparison group from the MAX data. Two-part regression models were used to estimate the impact of child maltreatment on expenditures. Data with individual identifiers were obtained under confidentiality agreements with the collecting agencies.
  
  
  RESULTS
  Children who were identified as maltreated or as being at risk of maltreatment incurred, on average, Medicaid expenditures that were >$2600 higher per year compared with children not so identified. This finding accounted for ~9% of all Medicaid expenditures for children.
  
  
  CONCLUSIONS
  Child maltreatment imposes a substantial financial burden on the Medicaid system. These expenses could be partially offset by increased investment in child maltreatment prevention.
authors.affiliation: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Analysis, Research and Practice Integration, Atlanta, Georgia 30341, USA. cflorence@cdc.gov
authors.forename: Curtis
authors.initials: C
authors.lastname: Florence
authors.forename: Derek S
authors.initials: DS
authors.lastname: Brown
authors.forename: Xiangming
authors.initials: X
authors.lastname: Fang
authors.forename: Hope F
authors.initials: HF
authors.lastname: Thompson
mesh_terms: D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000191:economics* / Q000706:statistics & numerical data / Q000639:trends; D002675:Child, Preschool; D017046:Cost Savings; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data* / Q000639:trends; D005102:Health Expenditures / Q000706:statistics & numerical data* / Q000639:trends; D006306:Health Surveys; D006801:Humans; D007223:Infant; D008297:Male; D008484:Medicaid / Q000191:economics* / Q000639:trends; D057216:Propensity Score; D014481:United States; D014947:Wounds and Injuries / Q000191:economics* / Q000453:epidemiology
keywords: Medicaid; child abuse; child maltreatment; expenditures; health care costs